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Treatment May Delay Surgery on Rodriguez’s Hip

TAMPA, Fla. — Several surgeons with expertise in Alex Rodriguez’s type of injury said Thursday that there was a range of treatment for a tear of the labrum in the hip and that Rodriguez might be able to play this season without surgery.

At best, they said, he could complete the season by modifying his exercise routine and undergoing therapy. At worst, he could soon need significant surgery that could keep him out of action for at least four months.

Among the more pessimistic was Dr. Carlos Guanche of Van Nuys, Calif., who said he had treated several major league players for the injury and that all needed surgery, although some tried to postpone it in order to play.

“They try to step it up and then they go backward and their pain level returns; they fool themselves,” Guanche said. “You hate to say 100 percent, but it’s pretty consistent that they cannot get back to their former professional level without surgery.”

Among the more optimistic was Dr. Thomas Byrd of Nashville. “Some people can adjust their training program and learn a few ways to modify their activities and continue to function at a high level for a long period,” said Byrd, who has treated major league players.

But Byrd also said this sometimes only postpones surgery and that starting such a plan in spring training is daunting. “Gosh, are they going to make it through all the games and all the months?” he said. “It’s a game of attrition.”

All doctors interviewed spoke by telephone and stressed that they were not discussing the Rodriguez case, but rather their experiences with similar cases.

They also stressed that a torn labrum was often a sign of a more serious bone problem in the hip socket. Surgery to correct either problem is usually arthroscopic, they said.

If the operation fixes only the torn labrum, the recovery period could be four to six weeks, they said. But if there is surgery to correct an underlying cause in the bones, recovery could take four months.

Dr. Robert Buly of the Hospital for Special Surgery in New York said there was a chance that therapy could work, but he added that a labrum torn as a result of bone problems would lessen the chances of recovery without surgery.

“If they have a lot of impingement, I think the chance of that patient doing well with conservative treatment is pretty low,” he said.

According to the Hospital for Special Surgery’s Web site, the labrum is a specialized piece of cartilage that runs along the rim of the hip socket and provides a suction seal and stability to the hip joint.

Dr. Gerald Finerman, the chairman of the department of orthopedic surgery at U.C.L.A., said mere rest would not help a torn labrum in the hip. “The only way to treat it is through surgery,” he said.

Dr. Joseph Zuckerman, the president of the American Academy of Orthopedic Surgeons and the chairman of the orthopedic surgery department at New York University Hospital for Joint Diseases, spoke of the cyst that Rodriguez reportedly had drained.

He and other doctors said a cyst is a normal occurrence in this sort of injury. “Usually when there is a cyst, it means that part of the labrum has detached and joint fluid has leaked out and caused the cyst,” Zuckerman said.

He added that activities like swinging a bat, running and sliding into bases were liable to make it worse.

“He’s a baseball player,” Zuckerman said. “He’s not an accountant or a doctor just walking around.”